| Objectives1.By observing the plasma Asymmetric dimethylarginine(ADMA) and Homocytokin- e(Hcy) of patients with cerebral white matte lesions (CCWML)and patients without it, to investigate the relationship between CCWML and ADMA and Hcy, and the correlation between ADMA and Hcy.2. To explore the pathogenesis that ADMA and Hcy lead to CCWML, so that theoretical basis for early diagnosis and early intervention of CCWML could be provided.Methods1. Case selecting: During the period of 2009-12 and 2010-11, 96 60--85 years old patients with Headache, dizziness, TIA and lacunar infarction were selected from the Neurology and Gerontology Department of Shandong Provincial Qianfoshan Hospital.1.1 Exclusion criteria:①Patients with multiple sclerosis, progressive multifocal leukoencephalopathy, hereditary white matter lesions, widespread cerebral infarction, viral encephalitis, metabolic encephalopathy, thyroid disease, disseminated brain myelitis, Parkinson's disease, autoimmune disease and cancer, et al.②Patients who was taking medication which might affect the results, such as anti-epileptic drugs, anti-Parkinson drugs and vitamins.1.2 All patients were supposed to take MRI scanning of the brain. According to Fazekas rating scale, the patients were divided into two groups:the positive group(including grade 1,2 and 3), 68 cases, and the negative group(grade 0), 28 cases. Fazekas rating scale: No lesion: grade 0; Speckle lesions: grade 1; Partly integrated lesions: grade 2; Widely integrated lesions : grade 3.2. Experiment methods:①For each patient, age, blood pressure and history of smoking and drinking were checked.②Fasting venous blood samples were taken from each patient, 5ml was for centrifugal separation and the following ELISA analysis of ADMA and Hcy; another 5ml was for biochemical analysis, includeing glucose, lipids and cholesterol, and the results were expressed as mean±sd ( X±S).3. Statistical Methods: All results were processed by SPSS13.0 statistical software. Logistic multiple regression was used to analyze the independent predictors. P < 0.05 represented a difference with statistical significance.Result1. ADMA level of the positive group (0.743±0.150umol/L) was significantly higher than that of the negative group (0.419土0.148 umol/L)(P<0.01). ADMA was positively correlated with hypertension and age (P<0.01),yet had no relevance with glucose,lipids, cholesterol, smoking and drinking.2. Hcy level of positive group (31.733士10.657 umol/L) was significantly higher than that of negative group (15.512土8.319umol/L) (P<0.01). Hcy was positively correlated with hypertension , age and glucose (P<0.01),yet had no relevance with lipids, cholesterol, smoking and drinking.3. In CWML subgroup analysis, ADMA of grade 3 patients (0.898土0.063 umol/L)was significantly higher than that of grade 2 patients (0.714土0.177 umol/L) (P<0.01); ADMA of grade 2 patients (0.714土0.177 umol/L was significantly higher than that of grade 1 patients (0.587土0.186 umol/L) (P<0.05); ADMA of grade 1 patients (0.587土0.186 umol/L) was significantly higher than that of grade 0 patients (0.419土0.148 umol/L) (P<0.05)。4. In CWML subgroup analysis, Hcy of grade 3 patients (41.451土4.757umol/L)was significantly higher than that of grade 2 patients (31.577土10.449 umol/L) (P<0.05);Hcy of grade 2 patients (31.577土10.449 umol/L)was significantly higher than that of grade 1 patients (23.464土10.526 umol/L) (P<0.05);Hcy of grade 1 patients (23.464土10.526 umol/L)was significantly higher than that of grade 0 patients (15.512土8.319umol/L) (P<0.05).5.Correlation analys showed that ADMA was positively correlated with Hcy。Conclusions1. Logistic multiple regression analysis showed that ADMA and Hcy might be independent predictors of CWML.2. The CWML subgroup analysis showed that CWML was positively correlated with ADMA and Hcy,which suggests ADMA and Hcy are important factors of CWML. 3. Correlation analysis showed that ADMA was correlated with Hcy,which suggests that ADMA might play a key role in the process of Hcy leading to CWML. |
PDF Full Text Request